EURURO Vol. 72 No. 4

Platinum Priority – Review – Prostate Cancer

Editorial by Jeremy P. Grummet, Karin Plass and James N’Dow on pp. 532–533 of this issue

Management of Prostate Cancer in Elderly Patients:

Recommendations of a Task Force of the International

Society of Geriatric Oncology

Jean-Pierre Droz

a , * ,

Gilles Albrand

b ,

Silke Gillessen

c ,

Simon Hughes

d ,

Nicolas Mottet

e ,

Ste´phane Oudard

f ,

Heather Payne

g ,

Martine Puts

h ,

Gilbert Zulian

i ,

Lodovico Balducci

j ,

Matti Aapro

Cancer–Environment Research Unit, Centre Le´on-Be´rard and Claude-Bernard Lyon 1 University, Lyon, France;

Groupement Hospitalier Sud des Hospices

Civils de Lyon, Hoˆpital Antoine Charial, Francheville, France;

Department of Oncology/Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;

Oncology Management Offices, Guy’s Hospital, London, UK;

Department of Urology, Saint-Etienne University Hospital, Saint-Priest en Jarez, France;

Oncology Department, Georges Pompidou Hospital, Rene´-Descartes Faculty, Paris 5 University, Paris, France;

Department of Oncology, University College

London Hospitals, London, UK;

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada;

Hoˆpital de Bellerive, Geneva University

Hospitals, Geneva, Switzerland;

H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa, FL, USA;

Clinique de Genolier, Genolier, Switzerland

E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 5 2 1 – 5 3 1

ava ilable at

www.sciencedirect.com

journal homepage:

www.eu ropeanurology.com

Article info

Article history:

Accepted December 29, 2016

Associate Editor:

James Catto

Keywords:

Prostate cancer

Geriatric assessment

Health evaluation

Comorbidities

Elderly

Guidelines

Abstract

Context:

Prostate cancer is the most frequent male cancer. Since the median age of

diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if

treatment is to be tailored to individual circumstances including comorbidities and

frailty.

Objective:

To update the 2014 International Society of Geriatric Oncology (SIOG) guide-

lines on prostate cancer inmen aged

70 yr. The update includes newmaterial on health

status evaluation and the treatment of localised, advanced, and castrate-resistant

disease.

Data acquisition:

A multidisciplinary SIOG task force reviewed pertinent articles pub-

lished during 2013–2016 using search terms relevant to prostate cancer, the elderly,

geriatric evaluation, local treatments, and castration-refractory/resistant disease. Each

member of the group proposed modifications to the previous guidelines. These were

collated and circulated. The final manuscript reflects the expert consensus.

Data synthesis:

Elderly patients should be managed according to their individual health

status and not according to age. Fit elderly patients should receive the same treatment as

younger patients on the basis of international recommendations. At the initial evalua-

tion, screening for cognitive impairment is mandatory to establish patient competence

in making decisions. Initial evaluation of health status should use the validated G8

screening tool. Abnormal scores on the G8 should lead to a simplified geriatric assess-

ment that evaluates comorbid conditions (using the Cumulative Illness Score Rating-

Geriatrics scale), dependence (Activities of Daily Living) and nutritional status (via

estimation of weight loss). When patients are frail or disabled or have severe comorbid-

ities, a comprehensive geriatric assessment is needed. This may suggest additional

geriatric interventions.

* Corresponding author. Cancer–Environment Research Unit, Centre Le´on-Be´rard and Claude-Bernard

Lyon 1 University, 24 Alle´e de Verdun, 69500 Bron, France. Tel. +33 643 178411.

E-mail address:

jpdroz@orange.fr

(J.-P. Droz).

http://dx.doi.org/10.1016/j.eururo.2016.12.025

0302-2838/